Rick Perry's position on Medicaid is hazardous to Texas' health

CORPUS CHRISTI - Some weeks it seems that the only social outings I get are to the grocery store and the doctor. That is an exaggeration, of course, but that is the way of life when you reach an age number that used to be the highway speed limit. I have to remember to do two things: take my reusable bag to the grocery store and take my insurance card to the doctor.

Millions of Texans do not have a health insurance card. Shamefully, Texas has the largest number of uninsured of any state in the nation. That is more than 6 million Texans, or about 24 percent of the state’s population.

They are uninsured, but that doesn’t mean they don’t get medical care. They get medical care when they are too sick to do anything but show up in emergency rooms.

That is not good for them; their health is deteriorated by letting things go too long without care, which means it is more difficult to get them healthy. That is not good for the rest of us; the cost of their health care, estimated to be about $4 billion annually, is picked up by local hospitals and local government and much of that shows up on our private insurance premiums and local tax rates.

Here’s the good news: The federal government, as part of the Affordable Care Act, aka, Obamacare, would cover 100 percent of the cost of expanding Medicaid to most of those uninsured, for the first years of the expansion and then 90 percent thereafter. The bad news is that Gov. Rick Perry is against expanding Medicaid in Texas.

It’s hard for me to tell whether Perry is against expanding Medicaid because it’s Obama’s idea — Perry would rather swallow a jug full of jalapeños than agree to anything that smacks of Obama — or whether he has real policy issues with the expansion. He says that it would cost the state about $15 billion in the long run. But the federal government would give Texas $100 billion in exchange. That sounds like a good trade to me.

Perry says that Medicaid is a broken system and it should be reformed before it is expanded. But several of Perry’s fellow Republican governors — Jan Brewer of Arizona, Rick Scott of Florida and Chris Christie of New Jersey — have already announced their support for the Medicaid expansion in their states. These are politicians who have made a living of skewering Obama, but they are in on Medicaid. Brewer has called Medicaid the “gold standard” for managed care across the country. That doesn’t sound like a broken system to me.

Perry has said that the Medicaid system is financially unsustainable. Yet if Texas doesn’t accept the Medicaid expansion, the state’s hospitals and clinics will continue to run up billions of dollars in costs while its taxpayers pay for Medicaid in other states.

How is it going to help the state prepare for the future if so many of its people have health problems that are going untreated, or treated only when they are on their last legs? Hispanics make up a huge portion of the uninsured. So when Perry is standing against Medicaid expansion, he is really blocking health care for the state’s future demographic base. If you want Texas to continue to be a strong economic leader, you need to take care of the people who will most likely work most of the jobs and pay most of the taxes.

Some Republican legislators who do see the demographic writing on the wall are poking around for a way to take the money but do it in a Republican kind of way. They think they may have found something in Arkansas. There, a Democratic governor dealing with a Republican-controlled Legislature is exploring an alternative path, proposing to use the Medicaid money to buy private health insurance for the low income. Some experts think this will be more expensive, but the point is that Republican politicians will find it easier to color it as conservative.

If Perry and conservatives want to stick pins in an Obama doll before they can allow themselves to take the Medicaid money, let them stick away. The point is that millions of Texans need efficient, individual health care.